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CVS, Aetna pilot Rx management program
August 20th, 2013
HARTFORD, Conn., and WOONSOCKET, R.I. – CVS Caremark Corp. is supporting a pilot program from health insurer Aetna that aims to help members with multiple prescriptions better manage their medications.
Under the Aetna Rx Home Success Program, announced Tuesday, CVS Caremark pharmacists and Dovetail Health will help Aetna members manage their health via personal support from a pharmacist, including in-home consultations. The medication management initiative focuses on people who have recently been discharged from a hospital, nursing home or rehabilitation facility.
The six-month pilot will be offered in the District of Columbia, Maryland, and Northern Virginia.
Members enrolling in the Aetna Rx Home Success Program are contacted by a pharmacist who will work with them to schedule an in-home visit or a phone consultation, the companies said. The pharmacist reviews new and/or pre-existing medications and helps devise a detailed care plan with members and their doctors.
The pharmacist will address medication-related issues, identify gaps in care and educate members about their medication. In addition, the pharmacist will examine other risk factors, such as chronic conditions and home safety, as well as assist in arranging doctor follow-up visits.
"We look forward to piloting this program with Aetna, as high rates of hospital readmissions result in increased costs for the patient and the payor, which can negatively impact a patient's health outcomes," Troy Brennan, executive vice president and chief medical officer at CVS Caremark, said in a statement. "Many patients who are newly discharged from a hospital or rehab facility are taking multiple medications. Trying to navigate multiple treatment guidelines provided by the patient's primary care physician and the treatment facility discharge team can be overwhelming. Our research shows that the intervention of a clinical pharmacist helps patients better understand their medications and avoid potential setbacks to recovery after returning home."
Through the program, members are identified by an Aetna case manager as "high risk" or "moderate risk" for hospital readmission, according to Aetna and CVS.
Within two days of discharge, high-risk members are contacted to schedule an in-home medication review by a Dovetail pharmacist. CVS Caremark pharmacists contact the moderate risk members to schedule a medication review over the phone. All members receive ongoing support through follow-up phone calls for a 30-day period. Aetna case management nurses for continuing care coordination also mentor members. After the 30 days, the member will be discharged from the program and moved back to Aetna case management for continued follow-up and care.
Readmission rates and member satisfaction of program participants will be measured at the end of the pilot.
"The average patient in the program takes over 10 prescription medications per day. Our pharmacists are uniquely trained to optimize these difficult medication regimens and lessen associated risks," explained Diane Gilworth, chief clinical officer at Dovetail Health. "Working with Aetna and CVS Caremark allows us to deliver a complete and coordinated approach to reduce readmission rates for some of the highest risk patients."
Hospital readmissions from not correctly taking medication affect nearly 3.5 million patients and result in about $15.2 billion dollars in health care costs each year, according to research cited by Aetna and CVS.
"We are very excited to partner with CVS Caremark and Dovetail Health on this program," stated William Fried, senior medical director of Aetna's Southeast Region. "By providing a personalized approach to health care, we can help our members stay on track with their medications, educate them about their treatment and prevent a repeated trip to the hospital."